Table of Contents 1 Pinyin 2 English Reference 3 National Essential Drugs 4 Basic Information on Magnesium Sulfate 4.1 Identification 4.2 Properties 4.3 Structure 4.4 Related Chemicals 5 Origin and Sources 6 Uses 6.1 Agriculture 6.2 Pharmaceuticals 6.3 Organic Chemistry 6.4 Other Uses 7 Hazardous 7.1 First Aid 7.2 Fire Fighting 7.3 Leakage Emergency Response 7.4 Operation, Disposal, and Storage 7.5 Exposure Controls/Personal Protection 8 Magnesium Sulfate Pharmacopoeia Standard 8.1 Name 8.1.1 Chinese Name 8.1.2 Chinese Pinyin 8.1.3 English Name 8.2 Molecular Formula and Molecular Weight 8.3 Source and Content 8.4 Properties 8.5 Identification 8.6 Inspection 8.6.1 Acidity and alkalinity 8.6.2 Clarification of solution 8.6.3 Chloride 8.6.4 Loss on fire 8.6.5 Iron salts 8.6.6 Calcium 8.6.7 Zinc salts 8.6. 8 Heavy Metals 8.6.9 Arsenic Salts 8.7 Determination of Content 8.8 Category 8.9 Storage 8.10 Preparation 8.11 Version 9 Instruction Manual for Magnesium Sulfate 9.1 Name of the Drug 9.2 Name in English 9.3 Alias for Magnesium Sulfate 9.4 Classification 9.5 Dosage Forms 9.6 Pharmacological Actions of Magnesium Sulfate 9.7 Pharmacokinetics of Magnesium Sulfate 9.8 Indications for Magnesium Sulfate 9.9 Contraindications for Magnesium Sulfate 9.10 Precautions 9.11 Adverse effects of magnesium sulfate 9.12 Dosage and administration of magnesium sulfate 9.13 Interactions between magnesium sulfate and other drugs 9.14 Expert review 10 Magnesium sulfate poisoning 10.1 Clinical manifestations 10.2 Diagnosis 10.3 Treatment 11 References Attachment: * Magnesium sulfate other versions of the drug inserts 1 Pinyin

liú suān měi

2 English reference

Epsom salt,magnesium sulfate,MGW,salamarum [Xiangya Medical Dictionary]

3 National Essential Drugs

National Essential Drugs related to Magnesium Sulfate

Serial No. Essential Drugs

Catalog No. Name of the Drug Formulations Specifications Unit Retail Price

Guiding Prices Category Remarks 639 90 Magnesium Sulfate Injectable 2.5g:10ml Bottle (Branch) 1.1 Chemical Drugs and Biological Products Section *△ 640 90 Magnesium Sulfate Injectable 1g:10ml Bottle (Branch) 0.55 Chemical Drugs and Biological Products Section

Note:

1. The products marked with "*" in the Remarks column of the table are representative products. for the representative product.

2. If the representative dosage form specification in the table is marked with "△" in the Remarks column, the price of the representative dosage form specification and its related specification with a clear differential relationship is the provisional price.

4 Magnesium sulfate basic information

Magnesium sulfate, or magnesium sulfate heptahydrate, is a compound containing magnesium, the molecular formula for MgSO4 (or MgSO4-7H2O). Anhydrous magnesium sulfate is a commonly used chemical reagent and drying reagent. However, magnesium sulfate is often referred to as magnesium sulfate heptahydrate because it does not dissolve easily and is easier to weigh than anhydrous magnesium sulfate, facilitating the quantitative control carried out in industry.

IUPAC English name Magnesium sulfate

Other names Lagoon salt

4.1 Identification

CAS number 7487889

4.2 Properties

Chemical formula MgSO4 (anhydrous)

MgSO4-7H2O (heptahydrate)

Molar mass 120.415 g mol1

Appearance White crystalline solid

Density 2.66 g/mL

Melting point 1124°C

Decomposition in water

Solubility 25.5 g/100 ml (20 °C)

4.3 Structure

Crystal structure Monoclinic

Hazard MSDS External MSDS

4.4 Related Chemicals

Other cations Calcium Sulfate, Aluminum Sulfate

5 Origin

Magnesium Sulfate originated in Jockey Horse (Epsom) and was produced by boiling local mineral water. Since then it has been obtained from seawater. In more recent times, magnesium sulfate has been extracted from minerals such as epsomite.

6 Uses 6.1 Agriculture

Magnesium sulfate is used as a fertilizer in agriculture because magnesium is one of the main components of chlorophyll. It is often used for potted plants or magnesium-deficient crops, such as tomatoes, potatoes, roses, and so on. The advantage of magnesium sulfate over other fertilizers is that it is more soluble.

6.2 Medicine

In medicine, magnesium sulfate is used to treat ingrown nail.

6.3 Organic Chemistry

Anhydrous magnesium sulfate is a very common desiccant in organic synthesis. When the organic phase is saturated with magnesium sulfate, the magnesium sulfate is removed by filtration or pipetting.

Many other inorganic salts are also used as desiccants, such as sodium sulfate, calcium sulfate.

6.4 Other Uses

Magnesium sulfate is also used as a bath salt.

7 Hazard

Health Hazard: The dust of this product has *** effect on mucous membranes, long-term exposure can cause inflammation of the respiratory tract. Misuse has diarrhea-inducing effect, and can cause magnesium poisoning if there is renal dysfunction, causing stomach pain, vomiting, watery diarrhea, defecation, respiratory distress, cyanosis, etc.

Environmental hazards.

Environmental hazards: Hazardous to the environment, can cause pollution of water bodies.

Hazard of combustion and explosion: This product is non-flammable, with *** sex.

7.1 First Aid

Skin Contact: Remove contaminated clothing and flush with running water.

EYE CONTACT: Lift eyelids and flush with running water or saline. Seek medical attention.

Inhalation: Remove from scene to fresh air. Keep airway open. If breathing is difficult, give oxygen. If breathing stops, administer artificial respiration immediately. Get medical attention.

Ingestion: Drink plenty of warm water and induce vomiting. Seek medical attention.

7.2 Fire Fighting Measures

Hazardous Characteristics: It is incombustible. Decompose by high heat and release toxic gas.

Harmful combustion products: sulfur oxide, magnesium oxide.

Fire-fighting methods: firefighters must wear full body fireproof and anti-virus clothing, in the upwind direction to extinguish the fire. As far as possible, the container will be moved from the fire to the open space. Then select the appropriate extinguishing agent to extinguish the fire according to the cause of the fire.

7.3 Emergency Response to Leakage

Emergency Response: Isolate the leaking contaminated area and restrict access. It is recommended that emergency personnel wear dust masks and general work clothes. Do not touch the leak directly. Small amount of leakage: avoid dust, sweep up carefully, collect and transport to the waste disposal site for disposal. Large spillage: collect and recycle or transport to waste disposal site for disposal.

7.4 Operation, Disposal and Storage

Operation Precautions: Sealed operation, local exhaust. Prevent dust from being released into the air of the workshop. Operators must be specially trained and strictly follow the operating procedures. It is recommended that operators wear self-absorbing filtering dust masks, chemical safety glasses, anti-poison penetration work clothes and rubber gloves. Avoid generating dust. Avoid contact with oxidizing agents. Equipped with emergency response equipment for leakage. Emptied containers may retain hazardous materials.

Storage Precautions: Store in a cool, ventilated warehouse. Keep away from fire and heat. Protect from direct sunlight. Packing sealed. It should be stored separately from oxidizers and should not be mixed. The storage area should be equipped with suitable materials to contain the leakage.

7.5 Exposure Controls/Individual Protection

Occupational Exposure Limits (OELs)

China MAC (mg/m3): No standard established

Former USSR MAC (mg/m3): 2

TLVTN: No standard established

TLVWN: No standard established

Monitoring Methods: Flame atomic absorption spectrometry. Dartan yellow colorimetric method

Engineering control: airtight operation, local exhaust.

Respiratory protection: When the dust concentration in the air exceeds the standard, you must wear a self-priming filtering dust mask. Emergency rescue or evacuation, you should wear an air respirator.

Eye protection: wear chemical safety glasses.

Body protection: Wear anti-poison penetration work clothes.

Hand protection: Wear rubber gloves.

Other protection: Smoking, eating and drinking are prohibited in the workplace. After work, shower and change clothes. Maintain good hygiene habits.

8 Magnesium Sulfate Pharmacopoeia Standard 8.1 Name 8.1.1 Chinese name

Magnesium Sulfate

8.1.2 Chinese pinyin

Liusuanmei

8.1.3 English name

Magnesium Sulfate

8.2 Molecular Formula and molecular weight

MgSO4-7H2O? 246.48

8.3 Source content

This product is used in accordance with the following formula Source content

This product is calculated according to the blazing to constant weight, containing MgSO4 shall not be less than 99.5%.

8.4 Properties

This product is colorless crystal; odorless, bitter, salty taste; weathering.

The product is soluble in water, almost insoluble in ethanol.

8.5 Identification

This product shows the identification reaction between magnesium salt and sulfate (2010 version of Pharmacopoeia II Appendix III).

8.6 Inspection 8.6.1 Acidity and alkalinity

Take 5.0g of this product, add 50ml of water to dissolve, add 3 drops of bromine musk oxalate phenol blue indicator solution; if it shows yellow color, add 0.10ml of sodium hydroxide titrant (0.02mol/L), strain blue-green color; if it shows bluish-green color or green color, add 0.10ml of hydrochloric acid titrant (0.02mol/L), strain yellow color.

8.6.2 Clarification of the solution

Take 2.5g of the product, add 20ml of water, shaking to dissolve, the solution should be clear; if turbid, compared with the No. 1 turbidity standard solution (2010 version of the Pharmacopoeia, Part II, Appendix IX B), shall not be more concentrated.

8.6.3 Chloride

Take 0.50g of this product, according to the law check (2010 version of the Pharmacopoeia, Part II, Appendix VIII A), compared with the standard sodium chloride solution made of 5.0 ml of control solution, shall not be more concentrated (0.01%).

8.6.4 Loss of weight by incandescence

Take 1.0g of this product, precision weighing, dry at 105 ℃ for 2 hours, and then at 450 ℃ ± 25 ℃ incandescent to constant weight, the loss of weight should be 48.0% ~ 52.0%.

8.6.5 Iron Salt

Take 2.0g of this product, add nitric acid solution (1 → 10) 5ml, boil for 1 minute, cool, dilute with water to 35ml, according to the law check (2010 version of the Pharmacopoeia, Part II, Appendix VIII G), compared with the standard iron solution 3.0ml of the control solution made in the same way, shall not be darker (0.0015%).

8.6.6 Calcium

Take the product 1.0g two, respectively, placed in a 100ml measuring flask, one with dilute hydrochloric acid 5.0ml, add water to dissolve and dilute to the scale, shaking, as a test solution; the other with the standard calcium solution (accurately weighed 105 ℃ drying to a constant weight of calcium carbonate 0.1250g, placed in a 500ml measuring flask, add 1mol / L hydrochloric acid solution) Dissolve 10ml, dilute with water to the scale, shake well, make a solution containing 0.1mg of calcium per 1ml) 2.0ml, add dilute hydrochloric acid 5.0ml, add water to dissolve and dilute to the scale, shake well, as a control solution. According to the atomic absorption spectrophotometry (2010 version of the Pharmacopoeia II Appendix Ⅳ D second method), the wavelength of 422.7nm were determined, should be consistent with the provisions (0.02%).

8.6.7 Zinc salt

Take 2.0g of this product, add 20ml of water to dissolve, add 1ml of acetic acid, add 5 drops of potassium ferrocyanide test solution, shall not show turbidity.

8.6.8 Heavy metals

Take 2.0g of this product, add 10ml of water to dissolve, add acetate buffer (pH 3.5) 2ml and water to make 25ml, add 0.5g of ascorbic acid to dissolve, according to the law, check (2010 version of the Pharmacopoeia, Part II, Appendix VIII, H, the first method), colorimetry in 5 minutes, the presence of heavy metals shall not be more than 10 parts per million.

8.6.9 Arsenic salt

Take 1.0g of this product, add 23ml of water to dissolve, add 5ml of hydrochloric acid, check according to law (2010 version of the Pharmacopoeia, Part II, Appendix VIII J, the first method), it should be in accordance with the provisions (0.0002%).

8.7 Determination of content

Take about 0.25g of this product, precision weighing, add 30ml of water to dissolve, add ammonia-ammonium chloride buffer (pH 10.0) 10ml and a little chrome black T indicator, titrate with disodium ethylenediamine tetraacetate titrant (0.05mol/L) until the solution is changed from violet red to pure blue. Each 1 ml of disodium EDTA titrant (0.05 mol/L) is equivalent to 6.018 mg of MgSO4.

8.8 Class

Laxative, choleretic.

8.9 Storage

Keep sealed.

8.10 Preparation

Magnesium Sulfate Injection

8.11 Version

Chinese People's **** and State Pharmacopoeia 2010 Edition

9 Magnesium Sulfate Instruction Manual 9.1 Name of the medicine

Magnesium Sulfate

9.2 English name

Magnesium Sulfate

9.3 Alias of Magnesium Sulfate

Dry Magnesium Sulfate; Bitter Salt; Sulfur Bitter; Laxative Salt; Laxative Salt; Medicinal Magnesium Sulfate; Epsom Salt

9.4 Classification

Neurological Drugs > Antiepileptic Drugs > Others

9.5 Dosage form

1.Injection: 1g (10ml), 2.5g (10ml);

2.Crystalline powder: 500g;

3.Solution: 3.3g (10ml).

9.6 Pharmacological effects of magnesium sulfate

1. Anticonvulsant and anti-muscle spasm: after injection of magnesium sulfate, magnesium ions can inhibit central nervous excitation, reduce the release of acetylcholine from neuromuscular junction, and reduce the sensitivity of motor neuron end plate to acetylcholine, produce sedation, relieve or reduce the contraction of transverse striated muscle, can also reduce intracranial pressure, and have preventive and therapeutic effects on eclampsia. Magnesium sulfate can also inhibit the action potential of uterine smooth muscle cells, so that the frequency of contractions is reduced and the intensity is weakened, so it can be used to treat preterm labor.

2. Diarrhea: Oral magnesium sulfate absorption, the water introduced into the intestinal cavity, intestinal fluid accumulation leads to abdominal distension, and *** intestinal peristalsis, thus playing a diarrhea. At the same time, magnesium sulfate prompts the intestinal wall to release cholecystokinin, to increase diarrhea.

3. Choleretic effect: small doses of magnesium sulfate can *** duodenal mucosa, reflexively cause relaxation of the sphincter of the common bile duct, gallbladder contraction, enhance bile drainage, promote gallbladder emptying, choleretic effect.

4. The role of the cardiovascular system: injection administration, excess magnesium ions can directly diastole peripheral vascular smooth muscle and cause sympathetic ganglion impulse transmission obstacles, thus making vasodilatation, blood pressure drop. In addition, intravenous administration of magnesium sulfate can prolong the effective not-to-exceed period of the cardiac conduction system, raise the threshold of ventricular fibrillation, and make myocardial repolarization uniform, reduce or eliminate refractory excitation, which is conducive to the control of tachyarrhythmias of the ventricular arrhythmia. It inhibits the autoregulation of sinus node, inhibits the conduction in sinus node, atrioventricular node, intra-atrial and intra-ventricular chambers, and inhibits various arrhythmias caused by triggering activity and foldback mechanism through activation of Na+K+ATPase by magnesium ions and blocking of potassium and calcium channels.

5. Anti-inflammatory swelling: magnesium sulfate 50% solution external hot compresses on the affected area, anti-inflammatory and swelling effect. It can also inhibit uterine contraction.

9.7 Pharmacokinetics of magnesium sulfate

Magnesium sulfate is orally absorbed by about 20%, takes effect in about 1h, and lasts for l~4h, intravenously injected almost immediately, and lasts for about 30min; intramuscularly injected, it takes effect in about 1h, and lasts for 3~4h. For the treatment of pre-eclampsia and eclampsia, the effective blood magnesium concentration is 2~3.5mmoL/L, and that for the treatment of preterm labor is 2.1~2.9mmoL/L. The effective blood magnesium concentration for the treatment of preterm labor is 2.1～2.9mmol/L, with relatively large individual differences. It is renally excreted after intramuscular or intravenous injection, and the rate of excretion is related to blood magnesium concentration and glomerular filtration rate. In the intestine to form a certain osmotic pressure, so that the intestine retains a large amount of water, *** intestinal peristalsis and excretion. It is difficult to absorb in the intestine, and a small amount of Mg2+ is absorbed and excreted in the urine.

9.8 Indications for magnesium sulfate

1. Magnesium sulfate injection is commonly used in hypertensive syndromes of pregnancy, preeclampsia and eclampsia. It is also used to treat preterm labor.

2. It is used for the prevention and treatment of hypomagnesemia, especially acute hypomagnesemia with muscle cramps and tetany. It is also used in total intravenous nutrition to prevent magnesium deficiency.

3. Used for ventricular tachycardia, including tip-twisting ventricular tachycardia and ventricular fibrillation prevention, also effective in digitalis and quinidine poisoning caused by ventricular tachycardia.

4. It is also used in patients with angina pectoris who have frequent episodes and are not well treated with other treatments, and is more effective in patients with hypertension.

5. It can also be used for convulsions, uremia, tetanus, hypertensive encephalopathy, acute renal hypertensive crisis.

6. Oral for diarrhea and duodenal drainage and treatment of constipation, abnormal fermentation in the intestine, biliary colic, obstructive jaundice and chronic cholecystitis.

7. Externally, it is used as a hot compress to reduce inflammation and swelling.

8. Remove intestinal toxins and some anthelmintic drugs after the diarrhea, made of one, two, three *** agent or Keselu, used for a variety of constipation. Mainly used for constipation, abnormal fermentation in the intestines, diarrhea after taking anthelmintic drugs, combined with medicinal charcoal to treat food or drug poisoning; also used for surgery, radiological examination and fiber colonoscopy before the bowel preparation.

9. It is mainly used for rapid ectopic arrhythmia caused by digitalis intoxication, tip-twisting tachycardia caused by prolongation of the QT interval due to class I and class III antiarrhythmic drugs, and it is more effective for those with hypomagnesemia.

9.9 Contraindications to magnesium sulfate

1. Heart block.

2. Myocardial damage.

3. Severe renal insufficiency with creatinine clearance less than 20 ml per minute.

4. Patients with intestinal bleeding.

5. Menstruating women.

6. Magnesium sulfate diarrhea is contraindicated in patients with acute abdomen and pregnant women.

7. It is forbidden to induce diarrhea in the poisoning of central inhibiting drugs, and it is forbidden to combine with ganglion blocking drugs.

9.10 Precautions

1. (1) Renal insufficiency, due to decreased renal function leading to reduced excretion of magnesium, magnesium accumulation and easy to occur magnesium poisoning. (2) Respiratory diseases, especially respiratory insufficiency. (3) Serious cardiovascular disease.

2. The effect of drugs on pregnancy: Intravenous injection can rapidly enter the fetal bloodstream through the placenta, so that the fetal blood concentration is equal to the mother's, magnesium on the role of the fetus and adults. Therefore, magnesium sulfate should not be used within 2h before delivery (unless magnesium sulfate is the only drug used to treat eclampsia).

3. The effect of the drug on the diagnosis or test value: the application of 99mTc colloidal sulfur for mononuclear phagocytosis system development, magnesium sulfate can make 99mTc colloidal sulfur agglutination and thus a large number of aggregates in the pulmonary vasculature into the liver, spleen, bone marrow and other reductions.

4. Before and after the drug and when the drug should be checked or monitored: (1) regular monitoring of electrocardiogram: (2) renal function; (3) blood magnesium concentration; (4) knee tendon reflexes check, in the repeated use of the drug before the knee tendon reflexes have been inhibited significantly, then can not be given again; (5) before the use of the drug should be measured respiratory rate. If the respiratory rate is lower than 16 beats per minute, the dosage should be reduced or even discontinued; (6) blood pressure should be monitored during intravenous injection or continuous titration.

5. Magnesium is mainly excreted by the kidneys, and the dosage should be reduced when renal insufficiency exists. Elderly due to the possibility of renal hypoperfusion, the dose should be reduced as appropriate.

6. The cardiopulmonary condition of the patient should be known before the use of the drug, cardiopulmonary toxicity, especially respiratory depression is the most dangerous adverse reaction of magnesium sulfate injection, which can quickly reach fatal respiratory paralysis, the respiratory rate of at least 16 breaths per minute before the injection of the drug.

7. Magnesium sulfate is a hypertonic laxative, can promote sodium retention and cause edema. If you need to induce diarrhea when taking central inhibiting drugs for poisoning, you should avoid using magnesium sulfate and use sodium sulfate instead.

8. When combined with calcium deficiency, first supplement magnesium, then calcium.

9. The diarrhea effect generally appears in 2-8h after taking the drug, so it is advisable to take it in the morning on an empty stomach, and drink a lot of water to accelerate the effect of diarrhea and prevent dehydration.

10. Common hypermagnesemia, can be seen in intravenous application, as well as as as a diarrhea choleretic and acid production drug oral application, especially in cardiac insufficiency. Generally when the plasma magnesium concentration exceeds 2 mmol/L, clinical manifestations can occur. These include flushed skin, thirst, decreased blood pressure, lethargy, loss of tendon reflexes, respiratory depression, cardiac arrhythmia, electrocardiogram showing prolongation of the PR interval and widening of the QRS wave, and even cardiac arrest. Coma, body temperature does not rise.

11. Treatment of hypermagnesemia: Calcium gluconate injection 10-20 ml of intravenous injection can be applied, dialysis therapy can rapidly remove magnesium ions from the body. Correct the hypovolemic state of the body and increase the urine output to promote the excretion of magnesium. Toxic lentil alkaloid injection is also applied subcutaneously, but not as a routine application. In acute magnesium poisoning, the drug should be stopped immediately, artificial respiration, and slow injection of calcium to rescue.

12. Gastrointestinal tract with ulcers, broken patients should pay attention to the use of magnesium ion poisoning, manifested as respiratory depression, the disappearance of knee tendon reflexes and decreased urine output.

Human Body Surface Area Calculator BMI Index Calculation and Evaluation Female Safe Period Calculator Due Date Calculator Normal Weight Gain in Pregnancy Pregnancy Medication Safety Classification (FDA) Five Elements and Eight Characteristics Adult Blood Pressure Evaluation Body Temperature Level Evaluation Diabetic Dietary Advice Clinical Biochemistry Common Units Conversion Basal Metabolic Rate Calculator Sodium Replacement Calculator Iron Replacement Calculator A Quick Look at the Commonly Used Latin Abbreviations for Prescriptions Commonly Used Symbols for Pharmacokinetics Quick Look Effective Plasma Osmolality Calculator Ethanol Intake Calculator

Medical Encyclopedia, Calculate Now!

9.11 Adverse Reactions to Magnesium Sulfate

1. Overdose can lead to electrolyte imbalance and hypermagnesemia, secondary to cardiac arrhythmia, confusion, myalgias, lethargy and weakness. It can even cause respiratory depression, sharp drop in blood pressure and cardiac arrest.

2. Concentration of too high a solution or too large a dosage when taking diarrhea, it absorbs a lot of water from the tissues and leads to dehydration. Continuous use of magnesium sulfate can cause constipation, and some patients may develop paralytic intestinal obstruction, which improves after stopping the drug. In high doses ***, serum magnesium is elevated and can cause central symptoms such as numbness, muscle paralysis and cardiac arrhythmias, and may also lead to respiratory paralysis.

3. Intravenous injection of magnesium sulfate often causes hot flashes, sweating, dry mouth and other symptoms, rapid intravenous injection can cause nausea, vomiting, panic, dizziness, individual nystagmus, slow down the injection rate of symptoms can disappear.

4. It can cause pain at the injection site and vasodilatation with heat sensation.

5. A few pregnant women may have pulmonary edema.

6. Rarely, blood calcium decreases and hypocalcemia occurs. Magnesium sulfate has a strong bitter taste and can cause nausea. Conducted diarrhea when taking too much, too high concentration of magnesium sulfate solution, can cause a large amount of tissue water loss, so that dehydration. Intravenous injection is more dangerous, must pay attention to the patient's respiration, blood pressure, there are toxic phenomena, can be injected intravenously 10% of the calcium gluconate injection 10 ml, in order to rescue.

9.12 Usage and dosage of magnesium sulfate

1. (1) Diarrhea: 5-20g per time, dissolved in 400ml of water and taken immediately. (2) Choleretic: 2～5g each time, 3 times a day, prepared as 33% or 50% solution to be taken.

2. Intramuscular injection: (1) mild hypertensive syndrome of pregnancy: 5g each time, depending on the condition 4 times a day or 4 hours once. (2) anticonvulsant: 1g each time. (3) prevention and treatment of hypomagnesemia: (1) mild magnesium deficiency: 1g of magnesium sulfate (4ml, 25% injection) each time, the total amount of 2g per day. (2) Severe magnesium deficiency: a one-time according to the body weight of 0.03g/kg of magnesium sulfate (0.25mmoL/kg magnesium). (4) Treatment of mild pre-eclampsia and eclampsia: 1-5g of magnesium sulfate will be prepared into 25%-50% injection, the dose will be decided according to the condition, and the maximum number of intramuscular injections will be 6 times a day, and ECG, tendon reflexes, respiration and blood pressure will be monitored.

3. Intravenous injection: (1) treatment of preeclampsia and eclampsia: 1 ~ 2g of magnesium sulfate will be formulated into 10% ~ 20% injection, the injection rate of not more than 0.15g per minute. intravenous injection of magnesium sulfate can make the blood magnesium concentration suddenly increased to close to the concentration of toxicity, must be strict control of dosage, and close observation of respiration, tendon reflexes and electrocardiogram. (2) Heavy gestational hypertension syndrome: first intravenous injection of 2.5~4g, diluted with 5% dextrose injection, slowly injected (over 5min), the extreme amount of 4g, and later maintained by intravenous drip, drip rate of about 2g per hour or 0.03g/kg per hour by body weight, the total amount can be up to 30g per day, knee tendon reflexes, respiration and urinary output as the monitoring indicators. (3) tip-twist arrhythmia treatment: the first injection of 2g, administration time more than 2min. subsequent continuous intravenous drip every minute 0.003 ~ 0.02g.

4. Intravenous drip: (1) light gestational hypertension syndrome: 1.5 ~ 2g per hour rate of drip, 15g per day. (2) severe gestational hypertension syndrome: see the intravenous injection item related to the content. (3) Anticonvulsant (3) Anticonvulsant: Intravenous drip, 1~2.5g per time, diluted to 1% concentration with 5% dextrose injection before use and drip slowly. (4) Prevention and treatment of hypomagnesemia: dissolve 2.5g of magnesium sulfate in 5% dextrose injection or sodium chloride injection, and slowly titrate for 3h. (5) Total intravenous nutrition, give 0.03～0.06g/kg of magnesium sulfate per day according to body weight. (6) Treatment of pre-eclampsia and eclampsia: 4g of magnesium sulfate added to 5% dextrose injection or sodium chloride injection in 250ml, the drip rate of not more than 4ml per minute. treatment of constipation: with *** or Kaiser fluid.

5. Used for rapid ectopic arrhythmia caused by digitalis intoxication, tip-twisting tachycardia caused by prolongation of the QT interval due to class I and class III antiarrhythmic drugs, with better efficacy for those with hypomagnesemia: 10% to 25% magnesium sulfate 20ml, diluted 1 times, slowly injected intravenously, and later intravenously dripped, 25% magnesium sulfate 20ml (5g) added to 5% glucose 25% magnesium sulfate 20ml (5g) added with 5% glucose solution 250ml drip, can be finished within 2h. The effect is rapid but the maintenance time is short.

9.13 Drug interactions

If they must be used, take into account the possibility that their interactions may lead to respiratory depression and have artificial respiration facilities available.

1. Magnesium sulfate eliminates cisplatin-induced renal damage.

2. Severe heart block or even cardiac arrest can occur in patients who have been digitalized with magnesium sulfate.

3. Simultaneous intravenous injection of calcium can antagonize the efficacy of magnesium sulfate in relieving convulsions.

4. Magnesium sulfate can antagonize ventricular arrhythmias caused by aminophylline.

5. The concomitant use of magnesium sulfate with the adrenergic beta agonist ritodrine increases cardiovascular toxicity.

6. Magnesium sulfate can reduce the absorption of ashwagandha and decrease the blood concentration.

7. With medicinal charcoal preparation of oral adsorption antidote, can reduce the absorption of poison and accelerate excretion.

8. Magnesium sulfate can form insoluble nontoxic barium sulfate with barium chloride for excretion, which can be used for oral barium chloride poisoning treatment.

9. Combined with oxytetracycline, gatifloxacin and norfloxacin, it can form a non-absorbable complex, reduce the absorption level of the latter, so that the latter's systemic blood concentration is reduced.

10. Magnesium sulfate can reduce oxytocin *** uterine effect.

11. Magnesium sulfate can reduce the excretion of quinidine via the kidneys, the mechanism of which may be related to urine alkalization.

12. Because the red tube drug contains quercetin, can be generated with Mg2 + chelate, when combined with the former efficacy is reduced.

13. Combined with Niu Huang anti-inflammatory pills, magnesium sulfate decomposition of trace sulfuric acid, sulfur contained in arsenic sulfide can be oxidized, increased toxicity.

14. and magnesium sulfate is a contraindication to the drug polymyxin B sulfate, streptomycin sulfate, calcium gluconate, dobutamine hydrochloride, procaine hydrochloride, tetracycline, penicillin and nafcillin (ethoxynaphthylpenicillin nafcillin).

9.14 Expert Comment

Magnesium ions can directly inhibit the action potential of uterine smooth muscle, inhibit the contraction of uterine smooth muscle, so that the contraction frequency is reduced, the intensity of the contraction is weakened, and can be used to treat preterm labor. Magnesium sulfate also has an inhibitory effect on the central nervous system, and at the same time has a diastolic effect on the vascular smooth muscle, so that the spasm of the peripheral vasodilatation, lower blood pressure, and thus have a therapeutic and preventive effect on eclampsia. See also magnesium valproate. Magnesium preparations are highly effective in tachyarrhythmias and tip-twisting ventricular tachycardia caused by digitalis intoxication, and it has been suggested that magnesium sulfate may be preferred for tip-twisting ventricular tachycardia. Atrial flutter and atrial fibrillation can be partially reversed, on a variety of antiarrhythmic drugs ineffective intractable premature ventricular may be effective, the original hypomagnesemia better.

10 Magnesium sulfate poisoning

Magnesium sulfate (sulfur bitter, laxative salts) due to different routes of administration present different pharmacological effects, internal diarrhea (each 5-20g), cholagogic (each 2-5g, 3 / d); injection (intramuscular injection of a lg, static injection of a 1-2.5g) sedative, antispasmodic, relaxation of skeletal muscle, vasodilatation, lowering blood pressure; external hot compresses to anti-inflammatory and swelling.

Central inhibitory drugs (such as phenobarbital) should not be used in patients with poisoning diarrhea, so as not to aggravate central inhibition. Mouse static LD50 is 0.31g/kg; rat static LD50 is 0.223g/kg.[1]

10.1 Clinical manifestations

[1]

1. Diarrhea, such as taking a large number of high concentration of the drug solution, may be sucked from the tissues of a large amount of water and lead to dehydration.

2. Too much or too fast sedation can cause poisoning. When the serum magnesium concentration reaches 4mmol/L, the deep tendon reflex disappears; when it reaches 4-7mmol/L, drowsiness, bradycardia, hypotension, weakened intestinal peristalsis, nausea, vomiting, diarrhea, urinary retention, and skin vasodilatation occur; when it reaches lOmmol/L, rhabdomyosarcoma paralysis and respiratory depression occur; when it reaches 15mmol/L, the heart stops beating. The electrocardiogram shows PR, QT interval prolongation, and intraventricular conduction delay, coolly resembling the effects of hyperkalemia.

10.2 Diagnosis

The key points in the diagnosis of magnesium sulfate poisoning are[1]:

A history of magnesium sulfate application with the above manifestations.

10.3 Treatment

The main points of the treatment of magnesium sulfate poisoning are[1]:

1. After oral administration of excessive magnesium salts, induce vomiting, gastric lavage, and drink a lot of water.

2. Symptoms of poisoning (such as respiratory muscle paralysis, etc.), can be used 10% calcium gluconate injection 10ml static injection. If necessary, repeat the application after 2h.

3. Toxic lentil alkaloid 0.5-1mg subcutaneous injection has therapeutic effect on respiratory and circulatory failure occurring in magnesium poisoning.

4. 5% dextrose saline was given intravenously to promote magnesium salt excretion and maintain fluid balance.